EAST HOUSTON MEDICINE & PEDIATRICS CLINIC PA
NPI 1083686091
Pediatrics in Houston, TX

Q: What is East Houston Medicine & Pediatrics Clinic PA's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Active since February 03, 2006

12739 WOODFOREST BLVD STE 2, HOUSTON, TX 77015(713) 450-4455(713) 450-4737 Get Directions Write a Review

NPPES record last updated: March 9, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 9, 2026, Sep 3, 2025, Jul 20, 2017 (3 updates tracked since 2017).

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About East Houston Medicine & Pediatrics Clinic Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EAST HOUSTON MEDICINE & PEDIATRICS CLINIC PA (NPI 1083686091) is a healthcare organization registered as a pediatrics in Houston, Texas and active in the NPI registry since February 2006. The organization lists Cornelius Antoinne Wilson, Owner President, as its authorized official.

NPPES Registry Identity

NPI1083686091

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameEAST HOUSTON MEDICINE & PEDIATRICS CLINIC PA

Location Address12739 WOODFOREST BLVD STE 2Houston, TX 77015-2737

Mailing AddressPo Box 24308Houston, TX 77229-4308 · (713) 450-4455 · Fax (713) 450-4737

Phone(713) 450-4455

Fax(713) 450-4737

Organization SubpartNo

Authorized OfficialCornelius Antoinne WilsonOwner President · (713) 450-4455

Enumeration DateFebruary 3, 2006

Last NPPES UpdateMarch 9, 20263 updates tracked since enumeration

NPPES CertifiedMarch 9, 2026

✔ NPI 1083686091 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedInternal Medicine · Adolescent MedicineTaxonomy 207RA0000X · License J2845 (TX)

12739 WOODFOREST BLVD STE 2, Houston, TX 77015

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Other Identifiers 5

Other0081QDTX · Blue Cross

Other00L66JTX · Bcbs

Medicaid184593501TX

Other45D1000292TX · Clia

Medicaid184593502TX

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

East Houston Medicine & Pediatrics Clinic Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to East Houston Medicine & Pediatrics Clinic PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Cornelius Wilson, M.D.

Internal Medicine

NPI 1215032586

12739 WOODFOREST BLVD STE 2
Houston, TX 77015

(713) 450-4455

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is East Houston Medicine & Pediatrics Clinic PA's NPI number?

The NPI number for East Houston Medicine & Pediatrics Clinic PA is 1083686091. It was assigned to this organization in the NPPES registry on February 3, 2006.

Where is East Houston Medicine & Pediatrics Clinic PA located?

East Houston Medicine & Pediatrics Clinic PA is located at 12739 Woodforest Blvd Ste 2, Houston, TX 77015. The listed phone number is (713) 450-4455.

What is East Houston Medicine & Pediatrics Clinic PA's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is East Houston Medicine & Pediatrics Clinic PA enrolled in Medicare?

Yes. East Houston Medicine & Pediatrics Clinic PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through East Houston Medicine & Pediatrics Clinic PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to East Houston Medicine & Pediatrics Clinic PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for East Houston Medicine & Pediatrics Clinic PA was last updated on March 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.